Review of Trends in Minnesota Health Insurance Coverage

Health Care Transformation Task Force

September 17, 2007

Julie Sonier

Director, Health Economics Program

Minnesota Department of Health

Sources of Insurance in Minnesota, 2001 and 2004

Source: 2001 and 2004 Minnesota Health Access Surveys

* Indicates a statistically significant difference from 2001.

68.4%

4.7%

21.2%

5.7%4.6% 7.4%*

25.1%*

62.9%*

0%

10%

20%

30%

40%

50%

60%

70%

80%

Employer Individual Public Uninsured

2001 2004

Factors Contributing to a Decline in Employer Coverage

Lower share of population employed in 2004 vs 2001 (72.3% vs 75.0%)

Changes in job characteristics. For example:– Increase in temporary/seasonal jobs– Smaller share of population working for very

large employers, where employer-based coverage is more likely

Decline in employer coverage was largely the result of declining access, not take-up

Access to Employer Coverage: Offer, Eligibility, and Take-up Rates, 2001 and 2004

Non-Elderly Minnesotans' Access to Employer-Based Insurance

84.1%

97.7% 95.3%

80.3%*

95.7%* 95.0%

0%

20%

40%

60%

80%

100%

Connection to Employer OfferingCoverage

Of Those With Connection, %Eligible

Of Those Eligible, % Enrolled(Take-up)

2001 2004

*Indicates a statistically significant difference from 2001.Source: 2001 and 2004 Minnesota Health Access Surveys

Private Health Insurance: Enrollment in Large Group, Small Group, and Individual Coverage, 2004

Individual6.3%

Small Group12.9%

Large Group80.8%

Source: MDH Health Economics Program

Private Health Insurance: Enrollment in Fully Insured and Self-Insured Plans, 1997 to 2005

Percent of Privately Insured Minnesotans with Fully-Insured vs Self-Insured Plans

0%

10%

20%

30%

40%

50%

60%

70%

1997 1998 1999 2000 2001 2002 2003 2004 2005

Fully Insured Self-Insured

Source: MDH Health Economics Program

Percent of Minnesota Businesses Offering Health Insurance, by Firm Size, 2006

*Indicates a statistically significant difference (95% level) from the rate for all firm sizes Source: preliminary results from 2006 Minnesota Employer Health Insurance Survey

42.3%*

71.2%*

91.9%*97.0%*

58.4%

0%

20%

40%

60%

80%

100%

Fewer than 10 10 to 49 50 to 199 200 or more All firm sizes

Percent of Minnesota Businesses Offering Health Insurance, by Region, 2006

*Indicates a statistically significant difference (95% level) from the statewide rateSource: preliminary results from 2006 Minnesota Employer Health Insurance Survey

48.4%* 49.5%*53.3%

65.2%*58.4%

0%

20%

40%

60%

80%

100%

Northwest Northeast South Twin Cities Statewide

Percent of Employees Working for a Firm That Offers Health Insurance, by Firm Size, 2006

*Indicates a statistically significant difference (95% level) from the rate for all firm sizes Source: preliminary results from 2006 Minnesota Employer Health Insurance Survey

44.5%*

75.6%*

91.9%99.4%*

88.6%

0%

20%

40%

60%

80%

100%

Fewer than 10 10 to 49 50 to 199 200 or more All firm sizes

Percent of Employees Working for a Firm That Offers Health Insurance, by Region, 2006

*Indicates a statistically significant difference (95% level) from the statewide rateSource: preliminary results from 2006 Minnesota Employer Health Insurance Survey

80.8%*88.2% 85.4%

90.4% 88.6%

0%

20%

40%

60%

80%

100%

Northwest Northeast South Twin Cities Statewide

0

100,000

200,000

300,000

400,000

500,000

600,000

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Note: Fully Insured market only.Source: MDH, Health Economics Program; estimates based on data from various sources.

Trends in Minnesota Small Group Health Insurance Enrollment, 1994 to 2006

Trends in Minnesota Individual Market Enrollment, 1994 to 2006

0

50,000

100,000

150,000

200,000

250,000

300,000

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006

Source: MDH, Health Economics Program; estimates based on data from various sources.

Sources of Insurance Coverage by Region, 2004

0%10%20%30%40%50%60%70%80%90%

100%

Group Individual Public Uninsured

Source: 2004 Minnesota Health Access Survey